Antiretroviral therapy, hepatitis C virus, and AIDS mortality among San Francisco's homeless and marginally housed
Antiretroviral therapy, hepatitis C virus, and AIDS mortality among San Francisco's homeless and marginally housed
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DOI：
10.1097/00126334-200502010-00010
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发表时间：
2005-02-01
影响因子：
3.6
通讯作者：
Moss, AR
中科院分区：
文献类型：
--
作者：
Riley, ED;Bangsberg, DR;Moss, AR
在大多数艾滋病毒感染人群中，死亡率已经下降，但在那些有障碍获得抗逆转录病毒(ARV)治疗的人中，死亡率仍然很高。我们试图确定旧金山一群感染艾滋病毒的无家可归者的死亡预测因素。1996至2002年间，进行了季度面谈和抽血。死亡风险通过前6个月所有个体服用任何抗逆转录病毒药物、药物使用、丙型肝炎病毒(丙型肝炎病毒)状态和住房状况进行比较。在330名参与者中，65%的人在基线时丙型肝炎病毒血清阳性，85%的人在研究期间接受了ARV，有57人死亡(每100人年5.3人)。与治疗前6个月的0相比，治疗1~5个月的患者死亡风险没有显著降低(风险比[HR]=0.82，95%可信区间[CI]：0.43~1.57)，但接受ARV治疗6个月的患者死亡风险降低了62%(HR=0.38，CI：0.19~0.76)。住房状况和丙型肝炎病毒状况并不是死亡的重要预测因素。艾滋病毒是导致这一人群死亡的主要原因，而丙型肝炎病毒感染的影响似乎很小。持续的抗逆转录病毒治疗大大降低了无家可归者的死亡风险。
Mortality has declined in most HIV infected populations yet remains high among those with barriers to accessing antiretroviral (ARV) therapy. We sought to determine predictors of death in a group of HIV-infected homeless persons in San Francisco. Between 1996 and 2002, quarterly interviews and blood draws were conducted. Hazards of death were compared by number of months of the prior 6 months that all individual took any ARV, drug use, hepatitis C virus (HCV) status, and housing status. Among 330 participants, 65% were HCV-seropositive at baseline, 85% received ARV during the study period, and there were 57 deaths (5.3 per 100 person-years). Compared with 0 of the prior 6 months on therapy, the risk of death was not significantly reduced for individuals on 1 to 5 months of therapy (hazard ratio [HR] = 0.82, 95% confidence interval [CI]: 0.43-1.57), but the risk of death was reduced 62% for those on ARV therapy for 6 months (HR = 0.38, CI: 0.19-0.76). Housing status and HCV status were not significant predictors of death. HIV is the major cause of death in this population, whereas the impact of HCV infection seems to be minimal. Sustained ARV treatment significantly reduces the risk of death among the homeless.